UNRAVELING PERINATAL MENTAL ILLNESS:

1
UNRAVELING PERINATAL MENTAL ILLNESS A POTENTIAL
ROLE FOR TESTOSTERONE AND DEHYDROEPIANDROSTERONE
SULFATE AS BIOMARKERS Chandler R. Marrs1, M.S.,
Douglas P. Ferraro, Ph.D. Department of
Psychology, University of Nevada Las Vegas, Las
Vegas, NV
1CONTACT mom.lab_at_unlv.edu 702-895-0547
INTRODUCTION
DISCUSSION

• These findings suggest that adrenal androgen
  synthesis marked by diminished late pregnancy
  testosterone and elevated puerperal DHEAS may
  underlie perinatal mental illness. While further
  investigation is merited, measurement of
  testosterone and DHEAS in late pregnancy may
  prove useful as predictors of postpartum
  psychiatric complications.

• Perinatal psychiatric disturbances are
  significant medical conditions with undetermined
  etiologies.
• Psychosocial and hormonal risk factors have been
  identified but with inconclusive empirical
  support.
• Accumulating evidence suggests that postpartum
  psychological disturbances
• May begin in late pregnancy with frank onset
  occurring in the days following parturition
• Are marked by a spectrum of anxiety and affective
  disturbances with varying levels of severity
• May be associated with changes in adrenal
  androgens.
• The present study prospectively examined the
  relationship between perinatal hormones and
  psychiatric disturbances in a cohort of healthy,
  primigravid women. The goal was to identify early
  biological markers of postpartum psychological
  morbidity.

RESULTS

• Psychological disturbances were observed both
  pre- and postpartum.
• Symptomatic women (n14) showed elevations in
  most SCL-90R symptom dimensions.
• Low late pregnancy testosterone was associated
  with increased psychological distress pre- and
  postpartum.
• High pre- and postpartum DHEAS was associated
  with increased pre- and postpartum psychological
  distress.
• 14 of 14 women with late pregnancy testosterone lt
  60pg/mL developed postpartum psychological
  disturbances (p.002).
• 4 of 4 women with postpartum DHEAS gt 2500pg/ml
  experienced psychological disturbances (p.028).
• 4 of 4 women with both low late pregnancy
  testosterone and high DHEAS experienced
  psychological distress (p.012).

• Data Analyses
• Bivariate Pearson product-moment correlations
  were used to capture relative trends in the data
  even though not all data conformed to normality
  (Shapiro-Wilkes statistic, plt 0.05). Use of rank
  analysis would obfuscate these trends and not
  provide a clear indication of the magnitude of
  variability found in hormone data. Thus, p-values
  associated with the Pearson correlations should
  be interpreted cautiously.
• Fishers Exact Test was used to test for
  independence in the 2X2 contingency tables.
• Data were collapsed post-hoc into symptomatic
  (SCL-90R T-score gt60 in 4 symptom domains) vs.
  asymptomatic.

METHODS

• Participants
• Twenty-seven, healthy, primigravid women, 21-40
  years old.
• Psychological Variables
• The Symptom-Checklist 90R (SCL-90R) measures
  anxiety, hostility, phobia, paranoia,
  psychoticism, somatization, obsessive compulsive
  behavior, interpersonal sensitivity depression
  and global severity of distress (GSI).
• Biological Variables
• Progesterone, DHEAS, testosterone, estrone,
  estradiol, estriol.
• Methods
• Pre-prandial, morning salivary samples collected
  at 37 weeks of pregnancy (T1) and within 10 days
  postpartum (T2).
• SCL-90R administered at T1 and T2.
• Specimen mailed to AllVia Diagnostic Lab,
  Phoenix, AZ, frozen and processed within 24 hours
  using industry standard ELISA protocols.
• Inter-assay CV progesterone 2.9 DHEAS 3.7,
  testosterone, 4.9, estrone 16.25, estradiol
  3.4, estriol 3.6.

Postpartum DHEAS (pg/mL)